Volunteer Application

I, (hereinafter, “PARTICIPANT”) agree to the following terms and provisions in consideration of my participation in the Kavod Senior Life volunteer program. Participant acknowledges and understands that volunteering undertaken with Kavod: Does not entitle the PARTICIPANT to reimbursement or compensation for such volunteer activities or any other benefit to which an employee or independent consultant might be entitled to in consideration for the performance of certain activities. Requires PARTICIPANT to follow the directions of the Kavod staff, and to abide by the policies and procedures of Kavod while carrying ou these volunteer services. These policies are written to provide overall guidance and direction to staff and PARTICIPANTS engaged in volunteer involvement and management efforts. Is with the understanding that such service is at the sole discretion of the agency. PARTICIPANTS agree that Kavod or PARTICIPANT may at any time, for whatever reason, decide to terminate the PARTICIPANT’s relationship with Kavod, following notice of the other party. Is with the understanding that PARTICIPANTS who do not adhere to the rules and procedures of Kavod or who fail to satisfactorily perform their volunteer assignments are subject to dismissal. No volunteer will be terminated until the volunteer has had an opportunity to discuss the reasons for possible dismissal with the Volunteer Services coordinator. Possible grounds for dismissal may include, but are not limited to: gross misconduct or insubordination, theft of property or misuse of agency materials, abuse or mistreatment of residents, staff or other volunteers, failure to abide by agency policies and procedures, and failure to satisfactorily perform assigned duties. Include diverse activities that may result in harm or injury to PARTICIPANT, whether physical or mental, or damage to property from the participation in such activities. May involve promotional activities including television, radio or newspapers and community programs such as LinkAGES that would cause sound recordings, photographs, and/or video to be taken and published of PARTICIPANT for the purpose of promoting Kavod and its activities. Requires PARTICIPANT’S unconditional permission for the use of such radio, television, photographic, video images, newsprint or sound recordings for promotion of Kavod its activities and programs. PARTICIPANT must refrain from entering any residential apartment unless approved in advance by the Volunteer Coordinator or management staff. Requires PARTICIPANT to adhere to all policies listed for five (5) years following volunteering termination. PARTICIPANT who engages in Zoom or any other online meeting forum assume all risks and assume all responsibility associated with this form of engagement. For more information regarding Zoom Meetings’ privacy policies please visit https://zoom.us/privacy. Being fully aware of the risks, nature, and conditions of the volunteer activities described above, PARTICIPANT agrees to waive, release, and discharge any claims for personal injury whether physical or mental, damage to property, or any other liability associated with the participation in volunteer activities and further agrees to hold harmless and indemnify Kavod, its officers and directors, employees, affiliated agencies, and volunteers (collectively referred to herein as “Kavod Volunteers” from any and all liability from any cause of action, claim, or suit resulting from participation in volunteer activities with Kavod. This agreement shall be binding upon PARTICIPANT’S assigners, heirs, personal representatives, and executors. By signing this agreement, I acknowledge that I have read, understand, and voluntarily agree to its terms. I also represent and warrant that I am of legal age to sign this agreement. If PARTICIPANT is a minor, I hereby consent as the parent or legal guardian of the PARTICIPANT to all the terms and provisions contained above and further acknowledge that I have read and understand the terms and provisions. My signature below affirms that all information on this information form is accurate to the best of my knowledge and I agree to abide by the conditions outlined above.

Confidentiality Policy The rights to confidentiality of the agency, the residents and the staff shall be respected by Kavod Senior Life volunteers. The Volunteer Services Coordinator will periodically conduct training as needed for volunteers regarding confidentiality. The Kavod volunteers shall, as far as possible, guarantee confidentiality and privacy in regard to records, discussions, and treatment of, or about, people we serve, co-workers, and agency business. The very fact that an individual is served by this organization must be kept private or confidential. The principle of confidentiality must be maintained in all programs, departments, functions, and activities. When questions arise, a supervisor and/or management can be consulted. The business of the agency, whether financial, strategy or status reports, is proprietary and also cannot be shared. Internal: All volunteers, regardless of position, will have access to such records on a need-to-know basis only. All volunteers will be reminded continually of the need to maintain confidentiality. “Gossip Sessions” and other non-professional discussions of Kavod individuals and records by volunteers are strictly forbidden. External: No unauthorized information about individuals or records will be released from this organization to State, Federal, or other agencies that would allow the identification of any person by name, address, social security number or any coding procedures. Volunteers should not discuss any individual’s or agency business with residents or unauthorized community members, formally or informally, whether on or off duty. Records will be kept safe from loss, destruction, theft and unauthorized use. No representations about admission policies or practices, waiting lists, vacancies, security or safety at Kavod Senior Life shall be made by unauthorized staff or volunteers. Acknowledgment I have read and understand the above statements.